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August Insurance News

A New Law in California  Will Mandate Insurance Coverage for Adults with Autism Providing Benefits for Behavior-Based Treatment

SB 946, was the bill that implemented the mandate.

Adults, teens and children with autism related disorders will now have coverage to Applied Behavior Analysis (ABA).


With the surge in autism diagnosis insurance coverage is vital to the future of our nations mental health as a whole.

Insurance Bill Summaries:

The following a summary of bills in various states around the nation in 2012

Alabama Autism Insurance Reform Bills:

Senate Bill 283 – Sponsored by State Senator Cam Ward (R-Alabaster) House Bill 345 – Sponsored by State Rep. Mac McCutcheon (R-Capshaw)

The bills would:

require providers of state-regulated insurance plans to provide coverage for the diagnosis and treatment of individuals with autism spectrum disorders through age 9 (Senate)/ through age 18 (House)
place no dollar cap on the annual benefit, except for ABA therapy at $50,000 per year
require coverage, following a determination of medical necessity by a licensed physician or psychologist, to include:
behavioral health treatment, such as applied behavior analysis (ABA)
pharmacy care
psychiatric care
psychological care
therapeutic care provided by a licensed or certified speech therapist, occupational therapist, or physical therapist
not apply to self-funded insurance plans since those plans are regulated by the federal government under ERISA

read more…

Summary of 2012 Alaska Autism Insurance Reform Bill
Senate Bill 74 – Sponsored by State Senator Johnny Ellis (D-Anchorage) House Bill 79 – Sponsored by State Representative Pete Petersen (D-Anchorage)
The bills would:

Require private health insurance companies to provide coverage for the diagnosis and treatment of autism spectrum disorder
Direct that a health care plan may not terminate coverage, or refuse to deliver, execute, issue, amend, adjust, or renew coverage to an enrollee solely because the individual is diagnosed with, or has received treatment for, an autism spectrum disorder
Require that coverage be provided only to individuals under 21 years of age
Impose no cap on the number of visits to a covered service provider
Impose no annual benefit dollar limit
Require that coverage not be subject to lifetime maximums, deductibles, copayments, or coinsurance or other terms and conditions that are less favorable than those that apply to physical illness generally under the health plan
Direct that coverage of treatments be provided when prescribed, provided, or ordered for an individual diagnosed with autism by a licensed physician or a licensed psychologist who determines the care to be medically necessary
Include coverage of the following treatments:

Habilitative or rehabilitative care – meaning professional counseling, guidance services, and treatment programs, including applied behavioral analysis (ABA) or other structured behavioral therapies necessary to develop, maintain, or restore, to the maximum extent practicable, the functioning of an individual
Pharmacy care
Psychiatric care
Psychological care
Therapeutic care – meaning services provided by or under the supervision of a licensed speech-language pathologist, occupational therapist, or physical therapist
Not affect any obligation to provide services to an individual under an individualized family service plan, an individualized education program (IEP), or an individualized services plan
Apply only to state-regulated insurance plans; they do not apply to self-funded insurance plans which are regulated by the federal government under ERISA law
Take effect immediately upon enactment and apply to health insurance policies that are offered, issued for delivery, delivered, or renewed on or after January 1, 2012

Courtesy of Autism speaks.   For more… 

 Scott Rupp, Missouri Secretary Of State Candidate, Could Win Via Autism Parents

A Republican locked in a three-way primary for Missouri secretary of state may find his past advocacy for those with autism pushes him over the edge in Tuesday’s vote.

Missouri political observers are saying that Sen. Scott Rupp’s (R-Wentzville) work to create a state law allowing autism to be covered by health insurance has endeared him to the state’s autism community and could help him win the primary. Rupp, whose campaign did not return a call for comment, took the lead on the legislation several years ago, including traveling around the state to gather input for the law that was signed in 2010. Rupp worked with Sen. Erik Schmitt (R-Glendale) on the issue.

The full story… http://www.huffingtonpost.com/2012/08/03/scott-rupp-missouri-autism-voters_n_1738886.html

Things are picking up around the nation for those afflicted with autism. Go ahead and share this to promote awareness of the need in many more states to follow the lead of these states.